Lean Manufacturing in Public Services: Prospects for Value Creation

The purpose of this paper is to investigate the utilization of lean manufacturing systems in public service operations for poten- tial added value. A case study of lean manufacturing implementation at a UK city council was carried out using in-depth interviews with key personnel coupled with documents collection. The Organizational Commitment Questionnaire (OCQ) was administered among front-line employees. Results show that lean manufacturing systems could create signi cant added value to the business and employees. A strong relation- ship was demonstrated between the lean manufacturing implementation and the a ective commitment level of employees. This paper is one of a few studies that demonstrate the applicability of manufacturing systems in other settings and that they can generate significant added value for the service department and its employees

The "reverse capture" autoantibody microarray: An innovative approach to profiling the autoantibody response to tissue-derived native antigens

Recently, we reported the development and use of a "reverse capture" antibody microarray for the purpose of investigating antigen-autoantibody profiling. This platform was developed to allow researchers to characterize and compare the autoantibody profiles of normal and diseased patients. Our "reverse capture" protocol is based on the dual-antibody sandwich immunoassay of enzyme-linked immunosorbent assay (ELISA), and we have previously reported its use to detect autoimmunity to epitopes found on native antigens derived from tumor cell lines. In this protocol, we used ovarian cancer as a model system to adapt the "reverse capture" procedure for use with native antigens derived from frozen tissue samples. The use of this platform in studies of autoimmunity is valuable because it allows for the detection of autoantibody reactivity with epitopes found on the post-translational modifications (PTMs) of native antigens, a feature not present with other protein array platforms. In the first step in the "reverse capture" process, tissue-derived native antigens are immobilized onto the 500 monoclonal antibodies that are spotted in duplicate on the array surface. Using the captured antigens as "baits," we then incubate the array with labeled IgG from test and control samples, and perform a two-slide dye-swap to account for any dye effects. Here, we present a detailed description of the "reverse capture" autoantibody microarray for use with tissue-derived native antigens

MAGIC very large zenith angle observations of the Crab Nebula up to 100 TeV

Aims. We measure the Crab Nebula γ-ray spectral energy distribution in the ~100 TeV energy domain and test the validity of existing leptonic emission models at these high energies. Methods. We used the novel very large zenith angle observations with the MAGIC telescope system to increase the collection area above 10 TeV. We also developed an auxiliary procedure of monitoring atmospheric transmission in order to assure proper calibration of the accumulated data. This employs recording optical images of the stellar field next to the source position, which provides a better than 10% accuracy for the transmission measurements. Results. We demonstrate that MAGIC very large zenith angle observations yield a collection area larger than a square kilometer. In only ~ 56 h of observations, we detect the γ-ray emission from the Crab Nebula up to 100 TeV, thus providing the highest energy measurement of this source to date with Imaging Atmospheric Cherenkov Telescopes. Comparing accumulated and archival MAGIC and Fermi/LAT data with some of the existing emission models, we find that none of them provides an accurate description of the 1 GeV to 100 TeV γ-ray signal

Antiinflammatory therapy with canakinumab for atherosclerotic disease

BACKGROUND: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. METHODS: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P=0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P=0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P=0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P=0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P=0.31). CONCLUSIONS: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. Copyright © 2017 Massachusetts Medical Society